Self–care and medication adherence amongst older persons in a rural area

Abstract

This study focuses on the older person with chronic diseases, something that yields them vulnerable to a decline in self–care and medication adherence. South Africa has the highest percentage of older persons in Africa, and the North–West Province where the study was conducted presents with 7.34% persons older than 60 years. The growing population of older persons not only poses challenges to the primary health care (PHC) facilities, but also to the older persons themselves, their family members and the community where they live. Health services to the older persons have become overshadowed by an emphasis on child– and maternal care, as well as communicable diseases such as HIV/AIDS and TB. The reality however is that the older population is subjected to an ageing process that predisposes them to a number of chronic diseases, such as hypertension, cardiac diseases, diabetes mellitus and arthritis. This often requires that the older person be put on multiple chronic medications and therefore be made aware of the importance of self–care and medication adherence to deal effectively with their chronic diseases and in turn improving quality of life. Non–experimental, quantitative research design was used to reach the aim of the study, namely to explore and identify possibilities for the enhancement of self–care and medication adherence of older persons in a rural area. This was done through objectives to explore and describe the factors of self–care and medication adherence in relation to age, gender, relationship status, behaviour and medication use amongst older persons in a rural area of the North–West Province. A literature review was first conducted by the researcher for a clear understanding of self–care and medication adherence of older persons. Thereafter a structured questionnaire consisting of a demographic–, self–care– and medication adherence section was employed. Trained field workers assisted with data collection. The questionnaires were distributed to 150 participants and 143 were completed in the homes of the older persons, resulting in a participation rate of 95%. Data collected was analysed in a sequential order; demographic data was first analysed with results shown in a frequency table; the exploratory factor analyses were done for data reduction on the self–care and the medication adherence questionnaire. Descriptive statistics and Cohen’s effect sizes for the factors of self–care and medication adherence in relation to age, gender, relationship status, behaviour and medication use amongst the older persons in a rural area. v The results revealed that the oldest participants, those older than 80 years, will seek help when they are unable to care for themselves, thus gender, relationship status and whether they smoke or not, showed no practical effect on self–care and medication adherence. There was however results that showed that different aspects of medication use can have a medium and/or large practical effect on factors of self–care and/or medication adherence. The results gave direction to the researcher to make recommendation to the nurses working in PHC facilities, future nursing research and nursing education.